Incongruency of youth food and physical activity environments in the United States: Variations by region, rurality, and income

Abstract

Local environments are increasingly the focus of health behavior research and practice to reduce gaps between fruit/vegetable intake, physical activity (PA), and related guidelines. This study examined the congruency between youth food and PA environments and differences by region, rurality, and income across the United States. Food and PA environment data were obtained for all U.S. counties (N = 3142) using publicly available, secondary sources. Relationships between the food and PA environment tertiles was represented using five categories: 1) congruent–low (county falls in both the low food and PA tertiles), 2) congruent–high (county falls in both the high food and PA tertiles), 3) incongruent–food high/PA low (county falls in high food and low PA tertiles), 4) incongruent–food low/PA high (county falls in low food and high PA tertiles), and 5) intermediate food or PA (county falls in the intermediate tertile for food and/or PA). Results showed disparities in food and PA environment congruency according to region, rurality, and income (p < .0001 for each). Nearly 25% of counties had incongruent food and PA environments, with food high/PA low counties mostly in rural and low-income areas, and food low/PA high counties mostly in metropolitan and high-income areas. Approximately 8.7% of counties were considered congruent–high and were mostly located in the Northeast, metropolitan, and high-income areas. Congruent–low counties made up 10.0% of counties and were mostly in the South, rural, and low-income areas. National and regional disparities in environmental obesity determinants were identified that can inform targeted public health interventions.